ANATOMIC AND RADIOLOGIC BASES OF COMBINED TRANSPLANTATION OF LIVER AND SMALL-INTESTINE IN THE PIG

In order to assess the tolerance induced by hepatic transplantation in a multivisceral graft, a model of a transplant combining the liver an d small intestine was developed in the pig, using animals of Large Whi te Isogroup O, typed in the system of major incompatibility as ''Swine lymphocyte antigen'' (SLA), whose weight varied from 30 to 40 kg. In order to limit the duration of warm ischemia, dissection of the graft was performed on the donor animal with respect for the following anato mic features: - absence of intestinal attachment to the posterior pari etal peritoneum, - anti-clockwise torsion of 360 degrees of the intest ine around the superior mesenteric a. with the small intestine convolu tions on the right and the colonic helix on the left. The bifid pancre as follows this rotation and its resection must respect the vascularis ation of the proximal small intestine; - the hepatic a. arises from a common trunk with a gastrosplenic branch of the aorta between the crur a of the diaphragm and travels sagittally from behind foward toward th e liver pedicle, which it reaches ar the upper border of the duodenum; - the hepatic a. and its branches are dorsal in relation to the porta l vein; - the hepatic arterial distribution follows a right-left and a ntero-posterior systematisation for the six hepatic lobes of this quad ruped animal.